Electronic Visit Verification (EVV) Claim Update: Providers using Sandata for claims submission are advised to allow 24 hours after claim submission for claim details to be visible in the Medicaid Management Information System (MMIS). Please be advised that claims must be submitted before noon Pacific Time on Fridays to be included in the following weeks’ remittance advice.
Unwinding COVID-19 Information
Known System Issues-Click HERE
Feedback Requested Regarding the Gabby™ Interactive Voice Response (IVR) System
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Paper claims are no longer accepted by Nevada Medicaid. Please refer to
Web Announcement 1733 and
Web Announcement 1829 for additional information.
Top 10 Claim Denial Reasons and Resolutions/Workarounds for June 2024 Professional Claims. See
Web Announcement 3398.
Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See
Web Announcement 3350.
Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023. See
Web Announcement 3280.
Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at
dhcfp.nv.gov and the Billing Guide for your provider type at
www.medicaid.nv.gov.